Hendrickson P
Department of Neurobiology, Harvard Medical School, 220 Longwood Avenue, Boston, Massachusetts 02115-5701, USA.
Klin Monbl Augenheilkd. 2000 Nov;217(5):289-95. doi: 10.1055/s-2000-10370.
An application of scanning-laser ophthalmoscopic flowmetry, Heidelberg Retina Flowmetry (HRF) is reported to faithfully quantify retinal perfusion. Indeed, without convincing regard for the fact that the method produces numerical values for such so-called "VELOCITY" (and subsequently "calculates" "FLOW", and "VOLUME") with no physical units or proven real-life meaning, current clinical drug studies and patient care are being based on this method. To test the physical "fidelity" of the HRF method, the author hence devised a simple, reliable mechanical model to generate known velocities of movement of a test surface.
Movement of the circumferential surface of an 89 mm (3 1/2-inch) Ø cylinder, belt-driven by a brass spindle with segments of increasing diameter, was "analyzed" with the HRF method. The true velocities (mm/sec) with which the surface passed the HRF's focal point were then determined using a stopwatch. A 10 degrees x 2.5 degrees measuring field and a 20 x 20-pixel analysis window were used. Measurements were made for horizontal, diagonal (45 degrees and 135 degrees), and vertical motion at all velocity settings of the model.
The relationship between real velocities of cylinder-surface motion and the corresponding HRF-"VELOCITY" values was nonlinear, an effect which increased significantly for diagonal and vertical motion.
Considering the dependency on orientation of motion and the non-linearity of the relationship between HRF results and true velocity, as well as several other weaknesses discussed herein, the question arises whether the validity of the HRF method should be reconsidered.
扫描激光检眼镜血流测量法的一种应用,即海德堡视网膜血流测量法(HRF),据报道可准确量化视网膜灌注。实际上,尽管该方法得出的所谓“速度”(随后还“计算”“流量”和“体积”)数值没有物理单位或经证实的现实意义,但目前的临床药物研究和患者护理却基于此方法。为了测试HRF方法的物理“保真度”,作者设计了一个简单、可靠的机械模型,以产生测试表面已知的运动速度。
使用HRF方法“分析”一个直径89毫米(3.5英寸)的圆柱体圆周表面的运动,该圆柱体由直径逐渐增大的黄铜心轴通过皮带驱动。然后使用秒表确定表面经过HRF焦点的真实速度(毫米/秒)。使用10度×2.5度的测量视野和20×20像素的分析窗口。在模型的所有速度设置下,对水平、对角线(45度和135度)和垂直运动进行测量。
圆柱体表面运动的实际速度与相应的HRF“速度”值之间的关系是非线性的,这种影响在对角线和垂直运动中显著增加。
考虑到对运动方向的依赖性、HRF结果与真实速度之间关系的非线性,以及本文讨论的其他几个弱点,是否应重新考虑HRF方法的有效性这一问题随之而来。